Initiate Lease Application – CoordinateThat.com

Agent Name*

First Last

Email*

Property Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Move-in Date:

Monthly Rent:

Security Deposit:

Initial Lease Term Requested

(months)

Property Condition: Applicant ___ viewed the Property in-person prior to submitting this application.

Has

Has not

Applicant is strongly encouraged to view the Property in-person prior to submitting any application.
Landlord makes no express or implied warranties as to the Property's condition. Applicant requests Landlord consider the following repairs or treatments should Applicant and Landlord enter into a lease:

Hidden

Repairs you feel need to done

Applicant was referred to Landlord by:*

Real Estate Agent Name*

First Last

Email*

Phone*

Other*

Applicant Information

Name:*

First Middle Last

Email:*

Hidden

Phone

Hidden

Social Security No.

Hidden

Drivers License No.

Hidden

Marital Status

Is there a co-applicant?

Yes

Co-applicant must submit a separate application

Authorization: Applicant authorizes Landlord and Landlord's agent, at any time before, during, or after any tenancy, to:

obtain a copy of Applicant's credit report;
obtain a criminal background check related to Applicant and any occupant; and
verify any rental or employment history or verify any other information related to this application with persons knowledgeable of such information.

Notice of Landlord's Right to Continue to Show the Property: Unless Landlord and Applicant enter into a separate written agreement otherwise, the Property remains on the market until a lease is signed by all parties and Landlord may continue to show the Property to other prospective tenants and accept another offer.
Privacy Policy: Landlord's agent or property manager maintains a privacy policy that is available upon request.
Fees: Applicant must a non-refundable fee of:

Non-Refundable Fee

Entity or Individual Name

Applicant ____ an application deposit

Will Submit

Will not submit

Deposit

to be applied to the security deposit upon execution of a lease or returned to Applicant if a lease is not executed.

Acknowledgement & Representation:

Signing this application indicates that Applicant has had the opportunity to review Landlord's tenant selection criteria, which is available upon request. The tenant selection criteria may include factors such as criminal history, credit history, current income and rental history.
Applicant understands that providing inaccurate or incomplete information is grounds for rejection of this application and forfeiture of any application fee and may be grounds to declare Applicant in breach of any lease the Applicant may sign.
Applicant represents that the statements in this application are true and complete.
Applicant is responsible for any costs associated with obtaining information.

The landlord, broker, or landlord's representative is:

Name

First Last

Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Phone

I give my permission:

to my current and former employers to release any information about my employment history and income history to the above-named person;
to my current and former landlords to release any information about my rental history to the above-named person;
to my current and former mortgage lenders on property that I own or have owned to release any information about my mortgage payment history to the above-named person;
to my bank, savings and loan, or credit union to provide a verification of funds that I have on deposit to the above-named person; and
to the above-named person to obtain a copy of my consumer report (credit report) from any consumer reporting agency and to obtain background information about me.

Note: Any broker gathering information about an applicant acts under specific instructions to verify some or all of the information described in this authorization. The broker maintains a privacy policy which is available upon request.